European Trainee Forum for Interventional Radiology

18/12/2025

premiere!

In our latest video with Dr. Osman Öcal, he discusses his contributions with the paper “Stent-graft implantation for hepatic arterial bleeding: a systematic review and meta-analysis”

https://youtu.be/QyFlhiqL2uc

17/12/2025

: Treatment of Severe Low Back Pain with Lumbar Medial Branch Cryoneurolysis

A 65-year-old female patient was presented with severe low back pain refractory to conservative treatment for approximately one year, including various analgesic medications and multiple physical therapy sessions. At the presentation, the Visual Analog Scale (VAS) score was 9.

Lumbar imaging demonstrated disc protrusions at the L2–3 and L3–4 levels, more pronounced on the left side. The patient reported bilateral pain, predominantly on the left, causing significant difficulty with mobility and sleep.

The procedure was performed under local anesthesia with the patient in the prone position, using combined ultrasound and fluoroscopic guidance. A 16-G cryoprobe with a length of 12 cm was advanced to the medial branch target. Cryoneurolysis was performed using carbon dioxide (CO₂), achieving a temperature of −88 °C, applied in two cycles of 2 minutes each, creating an approximately 7-mm ice ball. Bilateral cryoneurolysis was applied to the medial branches at the L3 vertebral level, and unilateral cryoneurolysis was applied to the left medial branch at the L4 level.

The patient experienced a noticeable reduction in pain during the procedure.
She was discharged ambulatory with significant pain relief. The post-procedural VAS score was 2.

Case courtesy: Mehmet Fatih İnecikli, Serhat Akış

16/12/2025

📅Check out the programme: https://t.ly/3Z9wz
👩🏻‍🏫Browse the faculty: https://t.ly/-MDxY
🎫 Secure your spot: https://t.ly/bTNqc

Chronic pain is a growing world-wide problem requiring a multidisciplinary approach. has a major role to play in pain management, offering effective, targeted solutions for a multitude of indications.
CIRSE is therefore organizing its first conference on image-guided pain management – ECIP 2026 – from March 19-20 in Vienna. As a purely scientific meeting with limited participants and without an exhibition, ECIP 2026 will let delegates focus on scientific exchange and strategizing. Registration is now open exclusively to CIRSE members – secure your spot today!

📅Check out the programme: https://t.ly/3Z9wz
👩🏻‍🏫Browse the faculty: https://t.ly/-MDxY
🎫 Secure your spot: https://t.ly/bTNqc

15/12/2025

is now available via the Library, free for all CIRSE members and All-Access Pass holders. ➡️ https://t.ly/pmtOD
Don't have your 2026 All-Access Pass yet? Get it today and start enjoying all benefits right away! ⭐ https://t.ly/19WCk

15/12/2025

This week, Dr. Marios-Platon Dimopoulos presents you his !

1. IO for colore**al liver metastases: the path to clinical excellence – C. Sofocleous
https://library.cirse.org/ecio2025/crs/221-2-honorary-lecture-2
2. How far have we gotten with ablation – D. Filippiadis
https://library.cirse.org/ecio2024/crs/141-1-how-far-have-we-gotten-with-ablation
3. Surgery versus thermal ablation for small-size colore**al liver metastases (COLLISION): a randomized, international, multicenter, phase III trial – M. Meijerink
https://library.cirse.org/cirse2024/crs/266-6-surgery-versus-thermal-ablation-for-small-size-colore**al-liver-metastases-collision-a-randomized-international-multicenter-phase-iii-trial
4. Radiation segmentectomy with SIRT: effectiveness, safety and dosimetry – K. Katsanos
https://library.cirse.org/cirse2023/crs/343-3-radiation-segmentectomy-with-sirt-effectiveness-safety-and-dosimetry
5. PANCOSIL Investigator-Initiated Study – CT-guided percutaneous administration of OncoSil™ - D. Vos
https://library.cirse.org/cirse2025/crs/466-2-safety-and-feasibility-of-ct-guided-percutaneous-radionuclide-therapy-with-the-oncosiltm-device-in-patients-with-non-progressive-locally-advanced-pancreatic-cancer-pancosil-an-open-label-single-arm-phase-1-2-feasibility-study

12/12/2025

Let's about it!

Our latest video features Dimitrios Filippiadis, who spoke about his paper "CIRSE Standards of Practice for the Classification of Complications – The Modified CIRSE Classification System."

https://youtu.be/8mzLzFXwFf4

12/12/2025

We present you the case of a 71-year-old male patient with chronic low back pain and radicular symptoms refractory to conservative treatment.

After more than 6 months of the NSAID therapy and physiotherapy, pain persisted. MRI demonstrated ligamentum flavum hypertrophy.

A fluoroscopy-guided transforaminal epidural steroid injection was performed under local anesthesia in the prone position. Using a 22° oblique detector angle, a 22G × 88 mm Chiba needle was advanced to the lateral superior aspect of the neural foramen. Needle position was confirmed in the lateral plane, and 2 cc of non-ionic contrast verified epidural placement.

A mixture of 8 mg dexamethasone and 15 mg 0.5% bupivacaine was injected into the epidural space.

Conclusion: Targeted image-guided intervention can make a significant difference in pain management - even in long-standing and cases unresponsive to initial therapy.

Case courtesy: Mehmet Fatih Inecikliö Serhat Akış

11/12/2025

A 60-year-old female with a previous medical history of disseminated re**al cancer presented to the hospital with worsening sacrococcygeal pain. Anesthesia performed a caudal epidural nerve block without sufficient pain relief. The patient was referred to interventional radiology for ganglion impar (coccygeal ganglion) nerve block.

With the patient prone, an AP craniocaudal view was obtained to locate the center of the sacrococcygeal joint in the coronal plane (not shown). Under fluoroscopic guidance in the lateral view, a needle was advanced through the sacrococcygeal ligaments and joint, with care not to advance the needle too far into the re**um. Correct needle placement was confirmed with loss of resistance and craniocaudal spread of contrast agent in the presacral region. Ganglion block with local anesthetics and steroids was performed.

📘 Read more:
▪️Factors associated with Successful Responses to Ganglion Impar Block: A Retrospective Study
https://pmc.ncbi.nlm.nih.gov/articles/PMC8241784/
▪️Assessment of Ganglion Impar Block Effect on Treatment Results of Coccydynia: A Cross-Sectional Study
https://pmc.ncbi.nlm.nih.gov/articles/PMC11088838/

10/12/2025

10/12/2025

A 75-year-old man with a previous medical history of hypertension and AAA rupture 4 weeks prior (Fig. 1).

At the time, the patient was urgently operated upon admission and an aortoiliac graft (Fig. 2a-b) was placed. The aneurysm sac was repaired.

At the follow-up 4 weeks later, the patient complained of low back pain and low-grade fever. Bloodwork showed a rise in inflammatory markers.

CT revealed that the aneurysm sac grew with increased peripheral enhancement and ruptured low-density fluid into the retroperitoneum (Fig. 3 a-b). There was clinical concern for abscess formation in the aneurysm sac with secondary rupture.

The patient was therefore referrred for drainage. With the patient prone, a translumbar drain was intially placed in the retroperitoneal fluid collection (Fig. 4a-b).

The blood inflammatory markers failed to drop despite drainage, and the patient's clinical status deteriorated. Colleagues in the MDT were reluctant to surgically open the abdomen and clean the aneurysm sac, and the decision was made to refer to IR for drain placement.

With the patient prone, two 16Fr pigtail drains were placed from either side into the aneurysm sac to allow irrigation (Fig. 5 a-b). There was immediate clinical improvement and the patient was subsequently discharged with active surveillance with CT.

10/12/2025

A few words from new Editor-in-Chief, Prof. Rob Morgan: https://link.springer.com/article/10.1186/s42155-025-00636-w

We’re excited to share the editorial from our new Editor-in-Chief, Prof. Rob Morgan 🚀
He reflects on the journal’s growth, outlines plans for strengthening CVIR Endovascular as a leading open-access platform, and invites specialists worldwide to submit their research, join the reviewer team & engage with our expanding community.
📘 Read the full editorial: https://link.springer.com/article/10.1186/s42155-025-00636-w
🌍 CVIR Endovascular: Multidisciplinary, Global, and

09/12/2025

: Low back pain

A 70-year-old man with previous medical history of indolent lymphoma and radical prostatectomy with lymphadenectomy 15 years prior. The patient suffered relapse of prostate cancer 5 years ago with pelvic bone metastases, treated successfully with GnRH antagonist. After a few weeks, the patient experienced increasing pain in the right hip and lower back.

MRI (Fig. 1a-c) showed metastasis in the third lumbar vertebra on the right side with extension towards the spinal canal and ipsilateral neural foramen. CT (Fig. 2a-c) showed local areas of bone sclerosis in the region. PSA is not measurable, and there is clinical concern for other another primary than prostate cancer. The patient was referred for biopsy prior to irradiation therapy.

With the patient prone, a generous amount of local anesthetic was injected to the periosteum at the right L3 pedicle (Fig. 3a).

A coaxial bone biopsy system (Boneopty 14G) with an outer coaxial needle and inner access needle with screw tip was employed through the cortex of the pedicle (Fig. 3b).

Once through, the screw needle was exchanged for a biopsy needle and advanced to target (Fig. 3c-d).
The system was retracted and the biopsy specimen released with the use of a pusher. Biopsy results were suspected for urothelial primary, and therefore the patient was referred to urologists for further assessment.

➡️ Learn more about the percutaneous needle biopsy (PNB):
https://ssvir.ch/app/uploads/2018/09/Percutaneous-Needle-Biopsy.pdf